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August 1965, Vol 91, No. 2 >
ARTICLE | August 1965

A Urine Precipitation Test for Intestinal Perforation

JOHN McCRAW, AB; RICHARD McLEOD; WALLACE McDONALD; HUGH E. STEPHENSON, MD
Arch Surg. 1965;91(2):248-252. doi:10.1001/archsurg.1965.01320140038008.
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THE LETHAL potential of gastrointestinal perforation is well known. The advantage of prompt recognition of this life-threatening event is also well known. The need for a safely administered, rapid, and easily interpreted laboratory test for gastric or intestinal perforation is obvious. The purpose of this report is to call attention to such a procedure. The procedure takes advantage of the rapid absorption of diatrizoate and its subsequent acid precipitation in the urine.

Method  Gastrointestinal perforations were produced in a series of 24 mongrel dogs. The perforations were placed in the stomach and at varying levels of the small bowel in 21 of the 24 dogs. Esophageal perforations were produced in two of the dogs and in one case diatrizoate was introduced directly into the pleural cavity. After perforation, diatrizoate was administered via a Levin tube. The time which elapsed between the perforation and the administration of dye varied from a

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